Individual
MS. LATISHA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT012800
Contact information
Practice address
3259 WASHINGTON RD APT 5, EAST POINT, GA 30344-5451
(404) 621-9416
Mailing address
3259 WASHINGTON RD APT 5, EAST POINT, GA 30344-5451
(404) 621-9416
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT012800
GA
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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